L-DOPA induced-endogenous 6-hydroxydopamine is the cause of aggravated dopaminergic neurodegeneration in Parkinson's disease patients

Dopamine replacement therapy by 3,4-dihydroxyphenylalanine (L-DOPA), which is the gold standard symptomatic treatment for the Parkinson's disease (PD), frequently leads to potential debilitating side-effects such as dyskinesia. One of the most significant molecules reported to be produced endogenously in the brain is 6-hydroxydopamine (6-OHDA), contributed solely by unsequestered dopamine in neurons derived from L-DOPA. It is further demonstrated that scavengers of hydroxyl radicals such as melatonin and salicylic acid inhibited its generation. However no reports on the level of 6-OHDA and hydroxyl radicals generated in vivo in human brain is known. Oxidative stress and mitochondrial dysfunction are known to be associated with Lewy body formation, which is directly dependent on the levels of free dopamine. Therefore, it is hypothesized that L-DOPA induced increase in endogenous 6-OHDA levels will have the ability to cause oxidative stress and mitochondrial dysfunctions that eventually leads to Lewy body formation in dopaminergic neurons resulting in its degeneration. Concomitant use of potent anti-oxidants along with L-DOPA would help in attenuating the neurodegeneration caused by endogenous 6-OHDA and would ultimately delay the progression of PD.     

An important role for autoimmunity in the immunopathogenesis of chronic allograft rejection

Organ transplantation is the treatment of choice for patients with end-stage organ dysfunction. In spite of advances in understanding of donor and recipient physiology, organ preservation, operative techniques and immunosuppression, long-term graft survival still remains a major problem primarily due to chronic rejection. Alloimmune responses to mismatched major histocompatibility antigens have been implicated as an important factor leading to rejection. However, there is increasing evidence pointing towards cross-talk between the alloimmune and autoimmune responses creating a local inflammatory milieu, which eventually leads to fibrosis and occlusion of the lumen in the transplanted organ i.e. chronic rejection. In this review, we will discuss recent studies and emerging concepts for the interdependence of alloimmune and autoimmune responses in the immunopathogenesis of chronic allograft rejection. The role of autoimmunity in the development of chronic rejection is an intriguing and exciting area of research in the field of solid-organ transplantation with a significant potential to develop novel therapeutic strategies towards preventing chronic allograft rejection.     

Characterization of the role of CD8+T cells in breast cancer immunity following mammaglobin-A DNA vaccination using HLA-class-I tetramers

INTRODUCTION: Mammaglobin-A(mam-A) is expressed in over 80% of human breast tumors. We recently reported that mam-A DNA vaccination resulted in breast cancer immunity in a preclinical model. Here we investigated whether mam-A HLA-class-I tetramers could be used to monitor and define the role of CD8(+)cytotoxic T-lymphocytes(CTL) in mediating breast cancer immunity following mam-A DNA vaccination. STUDY DESIGN: Mam-A DNA vaccination was performed in HLA-A2(+)huCD8(+ )transgenic mice. HLA-A2 tetramers carrying the immunodominant mamA2.1 peptide were used to monitor CD8(+)CTL. Human breast cancer colonies were developed in immunodeficient SCID-beige mice. ELISPOT was used to correlate frequency of mamA2.1 tetramer(+)CD8(+)T cells and IFN-gamma production [spots per million cells (spm)] in human subjects. RESULTS: Vaccination of HLA-A2(+)huCD8(+) mice with mam-A DNA vaccine, but not empty vector, led to the expansion of mamA2.1 tetramer(+)CD8(+)T-cells in peripheral blood (<0.5% pre-vaccination compared to >2.0% post-vaccination). CD8(+)T cells from vaccinated mice specifically lysed UACC-812(HLA-A2(+)/mam-A(+), 25% lysis) but not MDA-MB-415(HLA-A2(-)/mam-A(+)) or MCF-7(HLA-A2(+)/mam-A(-)) breast cancer cells. Adoptive transfer of purified CD8(+)T cells from vaccinated mice into immunodeficient SCID-beige mice with established human breast cancer colonies led to tetramer(+)CD8(+ )T-cell infiltration with regression of UACC-812 but not MCF-7 tumors. HLA-A2(+) breast cancer patients revealed increased frequency of mamA2.1 tetramer(+)CD8(+ )T-cells compared to normal controls (2.86 +/- 0.8% vs. 0.71 +/- 0.1%, P = 0.01) that correlated with the IFN-gamma response to mamA2.1 peptide (48.1 +/- 20.9 vs. 2.9 +/- 0.8 spm, P = 0.03). CONCLUSIONS: CD8(+ )T-cells are crucial in mediating breast cancer immunity following mam-A DNA vaccination. Mam-A HLA-class-I tetramers can be effectively used to monitor development of CD8(+ )T-cells following mam-A vaccination.     

Pretransplant warm B cell antibodies in recipients of primary and retransplanted cadaver renal allografts

Eighty-four recipients of cadaveric renal allografts were retrospectively crossmatched for donor-specific pretransplant B cell antibody. Of these, 28 were found to be positive for the antibody and 56 were negative. Actuarial survival analysis over six years revealed a slightly better graft survival overall in the B-cell-negative group as compared with the B-cell-positive group (P less than 0.07). These patients were further subgrouped into those who received primary transplants and those who were retransplanted. Fifty-four percent of the B-cell-positive group (15/28) consisted of retransplants, and only 13% (7/56) of the B-cell-negative group were retransplants. When considering primary transplants only, B-cell-negative and B-cell-positive groups had similar graft survival rates (P less than 0.25). When retransplants only were considered, the graft survivals of the B-cell-positive and B-cell-negative groups were comparable (P less than 0.32). The most significant differences were observed when comparing the B-cell-positive primary transplant group with the B-cell-positive retransplanted group. The primary transplants fared consistently better at all time intervals (P less than .007). Conversely, when primary and retransplants in the B-cell-negative group were compared, no differences were noted (P less than 0.29). Our results suggest that the identification of pretransplant B-cell antibodies may be indicative of a poorer allograft survival prognosis in patients who have been previously transplanted.     

Lack of T-cell tolerance of noninherited maternal HLA antigens in normal humans

Recent clinical reports of nonresponsiveness to noninherited maternal human leukocyte antigens have led to speculation that humans may acquire tolerance of noninherited maternal antigens through exposure to maternal cells neonatally or in utero. To test this hypothesis, we measured the responsiveness of normal subjects to their noninherited maternal and paternal antigens using cell-mediated lympholysis assays and mixed leukocyte reactions. All individuals exhibited cell-mediated lympholysis and mixed leukocyte reaction responses to the maternal cells that were comparable to those to the paternal cells. Limiting dilution analyses revealed significant cytotoxic T-lymphocyte precursor frequencies to both sets of parental antigens. To exlude the possibility that tolerance of individual noninherited maternal antigens was masked by the response to other antigens expressed on the same target cell, we raised cytotoxic T lymphocytes to the maternal cells and then tested for reactivity to a panel of targets that expressed single noninherited maternal HLA antigens. In all cases, each noninherited maternal antigen expressed on the maternal cells elicited a significant cell-mediated lympholysis response. An analysis of clinical data showed that pretransplant mixed lymphocyte reactions to maternal cells are not significantly lower than those to paternal cells. These data suggest that the reported B-cell tolerance of noninherited maternal antigens is not mediated by clonal deletion of T cells induced by exposure to the maternal cells neonatally or in utero.